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Calcitriol may predict hypercalciuria absence in postsurgical hypoparathyroidism
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The absence of hypercalciuria may be predicted by routine measurement of serum 1,25-dihydroxyvitamin D, or 1,25-(OH)2D, in patients with permanent postsurgical hypoparathyroidism treated with oral calcium and calcitriol supplements, study data show.
Luis García-Pascual , PhD, of the service of endocrinology, Hospital Universitari Mútua de Terrassa in Spain, and colleagues evaluated 34 stable outpatients with postsurgical hypoparathyroidism taking oral calcium and calcitriol supplements as well as 17 controls with hypothyroidism but without hypoparathyroidism. Researchers sought to identify useful predictive biomarkers of hypercalciuria. Participants were assessed during 54 observations.
Urinary calcium excretion was associated with BMI (P = .043), serum level of parathyroid hormone (P = .017) and serum level of 1,25-(OH)2D (P < .001) in the postsurgical hypoparathyroidism group. However, serum levels of 1,25-(OH)2D (P < .001) and serum levels of parathyroid hormone (P = .002) in the postsurgical hypoparathyroidism group remained significantly associated with urinary calcium excretion in the multiple linear regression analysis.
The absence of hypercalciuria was predicted with 100% sensitivity and 63.6% specificity by levels of serum 1,25-(OH)2D lower than 33.5 pg/mL. Hypercalciuria did not occur in any participant with serum 1,25-(OH)2D level less than 33.5 pg/mL regardless of level of albumin-corrected serum calcium.
“Our results suggest that serum [1,25-(OH)2D] should be added to the variables included in the follow-up of patients with permanent postsurgical hypoparathyroidism,” the researchers wrote. “The measurement of 24-hour urine calcium could be restricted to confirming hypercalciuria in those patients with serum levels of [1,25-(OH)2D] above 33 pg/mL. This approach seems both more reliable and more convenient that routine 24-hour urine collections. However, prospective studies to confirm these results are needed.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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